Health Care Law's First Anniversary: Why Haven't Americans Seen Changes Yet?

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Focus on preventative care: The law eliminates co-payments for preventative screenings such as mammograms and cancer screenings, and makes bonus payments to professionals who have high-quality ratings.

Young Americans' benefits: Young adults can now stay on their parents' insurance plans until the age of 26. The provision, one of the first to be implemented, was designed to help graduates who may be having trouble finding full-time employment with benefits.

Tighter restrictions on insurance providers: Insurers can no longer cancel coverage of patients who get sick, except in cases where the policy holder commits fraud. This provision applies primarily to the individual insurance market. Insurance companies are also barred from imposing a lifetime limit on co-payments.

Small business benefits: Small businesses that establish wellness programs are eligible for federal grants.

Help for states: The Obama administration has given millions to help create and strengthen state insurance rate review processes. These systems vary widely all over the country, and only a handful of states have the authority to deny rate increases. While the new law aims to strengthen rate reviews, it doesn't give states the power to reject rates.

Tanning tax: Indoor tanning salons are now subject to a 10 percent tax that took effect last year.

Help for sick children: Health insurance companies are prohibited from dropping children with pre-existing conditions. Similar measures for adults with pre-existing conditions will be rolled out in the coming years.

Medical Loss Ratio for Insurers: Under the new law, insurance companies serving the large group market will have to devote 85 percent of every dollar to patient care and improving quality of care, and not to such expenses as overhead costs, executive salaries or dividends for shareholders. For those serving small business and individuals, that has to amount to 80 percent of every dollar.

If insurance companies fail to meet these standards, they will have to provide rebates to consumers.

The medical loss ratio -- the ratio of medical expenses to administrative spending -- came under fire last year when some companies, such as McDonald's, reportedly threatened to drop limited coverage plans because of the new standards.

Medicaid Expansion: A new program will go into effect that will provide matching federal funds for long-term care services under Medicaid. The federal government will also provide funds for home health care and attending services for people with disabilities.

The Medicaid expansion under the new health care law has met with resistance from many state governments that say it puts additional burdens on them at a time when they're struggling with budget deficits.

High risk pools: Programs have already been established in some states to provide temporary insurance to those people who have been denied insurance because of pre-existing conditions for at least six months. The high risk pools and premiums differ from state to state.

Premiums can range anywhere from $140 to $900, HHS said in July, with older people having to pay more. The premiums are linked to individual health insurance costs in each state.

Changes Still to Come

Here is what Americans can expect this year and in the coming years:

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